From the Guidelines
Gastrojejunostomy (GJ) tubes are indicated for patients with impaired gastric emptying, altered intestinal anatomy, or those who require simultaneous gastric decompression and jejunal feeding, whereas G-tubes are suitable for patients with normal gastric emptying and low risk of aspiration. The choice between G-tubes and GJ-tubes depends on the patient's specific clinical condition, risk factors, and long-term nutritional needs 1.
Key Indications for GJ Tubes
- Impaired gastric emptying
- Altered intestinal anatomy, such as after bariatric or foregut surgery
- Need for simultaneous gastric decompression and jejunal feeding
- Conditions like pancreatitis, chronic vomiting, or previous gastric surgery
Key Indications for G Tubes
- Normal gastric emptying
- Low risk of aspiration
- Neurological impairment, head and neck cancers, or other conditions preventing adequate oral intake Some key points to consider when deciding between G-tubes and GJ-tubes include the patient's risk of aspiration, gastric emptying function, and the need for simultaneous gastric decompression and jejunal feeding 1.
Considerations for Tube Placement
- Percutaneous tube placement is typically reserved for individuals who are expected to require enteral access for 4 or more weeks
- Nasoenteral feeding tubes are preferred for short-term use (<4 weeks)
- The small bowel can be accessed with NJ tube placement, jejunal extension tubes placed through a PEG tube (PEG-J), or unitized transgastric jejunostomy tube and DPEJ 1.
From the Research
Indications for GJ Tube vs G Tube
- Gastrostomy (G) tubes are indicated for patients who require enteral nutrition and have a functioning stomach 2, 3.
- Gastrojejunostomy (GJ) tubes are indicated for patients with severe gastroesophageal reflux disease, gastric outlet obstruction, or severe gastric dysfunction or gastroparesis 2, 4.
- Postpyloric feeding tubes, such as GJ tubes, are preferable to gastric feeding tubes if patients have a history of aspiration, gastroesophageal reflux, severe gastroparesis, and/or recurrent nausea and vomiting 2.
- Feeding jejunostomy tubes, such as GJ tubes, are indicated if gastric feeding is unsafe or impossible 2.
- Dual-lumen gastrojejunostomy tubes are used when both gastric decompression and feeding are desired 2.
Specific Indications for GJ Tubes
- Severe gastroparesis with oral intolerance of food 4.
- Severe gastroesophageal reflux disease 4.
- Gastric outlet obstruction 4.
- Severe gastric dysfunction 4.